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Early warning scores

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https://www.readbyqxmd.com/read/28445859/a-risk-scoring-model-based-on-vital-signs-and-laboratory-data-predicting-transfer-to-the-intensive-care-unit-of-patients-admitted-to-gastroenterology-wards
#1
Won-Young Kim, Jinmi Lee, Ju-Ry Lee, Youn Kyung Jung, Hwa Jung Kim, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
PURPOSE: To compare the ability of a score based on vital signs and laboratory data with that of the modified early warning score (MEWS) to predict ICU transfer of patients with gastrointestinal disorders. MATERIALS AND METHODS: Consecutive events triggering medical emergency team activation in adult patients admitted to the gastroenterology wards of the Asan Medical Center were reviewed. Binary logistic regression was used to identify factors predicting transfer to the ICU...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#2
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28441797/breast-cancer-awareness-among-women-in-western-amazon-a-population-based-cross-sectional-study
#3
Marla Presa Raulino Schilling, Ilce Ferreira da Silva, Simone Perufo Opitz, Maria Fernanda de Sousa Oliveira Borges, Sergio Koifman, Koifman Rosalina Jorge
Background: A general lack of women`s awareness of breast cancer has been one of the barriers to screening and early presentation. Thus, the aim of this study was to evaluate levels of knowledge about risk factors, and early warning signs of breast cancer, and to determine factors associated with better levels of comprehension. Methods: A population-based cross-sectional study was carried out among 478 women over 40 years old, living in Rio Branco city, western Amazon. All were interviewed using the “Breast cancer knowledge, attitudes and practice scale”, developed by American Cancer Society...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28440892/the-effect-of-adult-early-warning-systems-education-on-nurses-knowledge-confidence-and-clinical-performance-a-systematic-review
#4
REVIEW
Mohamad M Saab, Bridie McCarthy, Tom Andrews, Eileen Savage, Frances J Drummond, Nuala Walshe, Mary Forde, Dorothy Breen, Patrick Henn, Jonathan Drennan, Josephine Hegarty
AIMS: This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. BACKGROUND: Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognise and manage deteriorating patients. Little is known as to the effectiveness of these programmes. DESIGN: SYSTEMATIC REVIEW: DATA SOURCES: Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October - November 2015...
April 25, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28440868/improved-outcomes-after-successful-implementation-of-a-pediatric-early-warning-system-pews-in-a-resource-limited-pediatric-oncology-hospital
#5
Asya Agulnik, Lupe Nataly Mora Robles, Peter W Forbes, Doris Judith Soberanis Vasquez, Ricardo Mack, Federico Antillon-Klussmann, Monica Kleinman, Carlos Rodriguez-Galindo
BACKGROUND: Hospitalized pediatric oncology patients are at high risk of clinical decline and mortality, particularly in resource-limited settings. Pediatric early warning systems (PEWS) aid in the early identification of clinical deterioration; however, there are limited data regarding their feasibility or impact in low-resource settings. This study describes the successful implementation of PEWS at the Unidad Nacional de Oncología Pediátrica (UNOP), a pediatric oncology hospital in Guatemala, resulting in improved inpatient outcomes...
April 25, 2017: Cancer
https://www.readbyqxmd.com/read/28434059/early-warning-score-independently-predicts-adverse-outcome-and-mortality-in-patients-with-acute-pancreatitis
#6
Michael J Jones, Christopher P Neal, Wee Sing Ngu, Ashley R Dennison, Giuseppe Garcea
PURPOSE: The aim of this study was to compare the prognostic value of established scoring systems with early warning scores in a large cohort of patients with acute pancreatitis. METHODS: In patients presenting with acute pancreatitis, age, sex, American Society of Anaesthesiologists (ASA) grade, Modified Glasgow Score, Ranson criteria, APACHE II scores and early warning score (EWS) were recorded for the first 72 h following admission. These variables were compared between survivors and non-survivors, between patients with mild/moderate and severe pancreatitis (based on the 2012 Atlanta Classification) and between patients with a favourable or adverse outcome...
April 22, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28421894/how-learning-analytics-can-early-predict-under-achieving-students-in-a-blended-medical-education-course
#7
Mohammed Saqr, Uno Fors, Matti Tedre
AIM: Learning analytics (LA) is an emerging discipline that aims at analyzing students' online data in order to improve the learning process and optimize learning environments. It has yet un-explored potential in the field of medical education, which can be particularly helpful in the early prediction and identification of under-achieving students. The aim of this study was to identify quantitative markers collected from students' online activities that may correlate with students' final performance and to investigate the possibility of predicting the potential risk of a student failing or dropping out of a course...
April 19, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28417836/cervical-spine-status-of-pilots-and-air-controllers-of-airborne-early-warning-and-control-aircraft
#8
Young Ho Shin, Chul Yun, Andrew Hogyu Han
INTRODUCTION: Many countries have developed their own airborne early warning and control (AEW&C) systems for use in surveying their territorial sky in real time. However, a review of the literature suggests that no studies have been conducted to analyze the cervical spine of pilots and air-controllers of AEW&C aircraft. METHODS: The study subjects were 80 pilots and air-controllers of AEW&C aircraft with a period of service of > 1 yr and had data on physical examinations, simple radiographs and functional scores of the axial skeleton, and questionnaires about lifestyle and working conditions...
May 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#9
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28401657/validation-of-a-modified-early-warning-score-linked-situation-background-assessment-recommendation-sbar-communication-tool-a-mixed-methods-study
#10
Debora Burger, Sue Jordan, Una Kyriacos
AIMS AND OBJECTIVES: The objective of this study was to develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town Modified Early Warning Score vital signs chart for reporting early signs of clinical deterioration. BACKGROUND: Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28385419/vital-signs-and-other-observations-used-to-detect-deterioration-in-pregnant-women-an-analysis-of-vital-sign-charts-in-consultant-led-uk-maternity-units
#11
G B Smith, R Isaacs, L Andrews, M Y K Wee, E van Teijlingen, D E Bick, V Hundley
BACKGROUND: Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. METHODS: One hundred and twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands...
March 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28351424/variables-associated-with-unplanned-general-adult-icu-admission-in-hospitalised-patients-protocol-for-a-systematic-review
#12
James Malycha, Tim Bonnici, Katarina Sebekova, Tatjana Petrinic, Duncan Young, Peter Watkinson
BACKGROUND: Failure to promptly identify deterioration in hospitalised patients is associated with delayed admission to intensive care units (ICUs) and poor outcomes. Existing vital sign-based Early Warning Score (EWS) algorithms do not have a sufficiently high positive predictive value to be used for automated activation of an ICU outreach team. Incorporating additional patient data might improve the predictive power of EWS algorithms; however, it is currently not known which patient data (or variables) are most predictive of ICU admission...
March 28, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28351349/development-and-validation-of-the-efficacy-safety-score-ess-a-novel-tool-for-postoperative-patient-management
#13
Erlend Skraastad, Johan Ræder, Vegard Dahl, Lars J Bjertnæs, Vladimir Kuklin
BACKGROUND: Several reports have shown that postoperative monitoring of general safety and quality issues, including pain treatment, after discharge from recovery is often non-systematic and inadequate. We suggest a new score with assessment of key recovery parameters, as a supportive tool for postoperative care and a call-out algorithm for need of extra help. The aim of this investigation was to validate the score. METHODS: After suggesting a prototype score from a pilot study in 182 postoperative patients, we performed a Delphi process by using international experts to create consensus on the final score contents and called the revised tool the Efficacy Safety Score (ESS)...
March 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28339626/a-ward-based-time-study-of-paper-and-electronic-documentation-for-recording-vital-sign-observations
#14
David Wong, Timothy Bonnici, Julia Knight, Stephen Gerry, James Turton, Peter Watkinson
Objective: To investigate time differences in recording observations and an early warning score using traditional paper charts and a novel e-Obs system in clinical practice. Methods: Researchers observed the process of recording observations and early warning scores across 3 wards in 2 university teaching hospitals immediately before and after introduction of the e-Obs system. The process of recording observations included both measurement and documentation of vital signs...
February 11, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28320425/patient-compliance-with-touchdown-weight-bearing-after-microfracture-treatment-of-talar-osteochondral-lesions
#15
Gökhan Polat, Gökhan Karademir, Ekin Akalan, Mehmet Aşık, Mehmet Erdil
BACKGROUND: The aim of this study was to prospectively evaluate the compliance of our patients with a touchdown weight bearing (without supporting any weight on the affected side by only touching the plantar aspect of the foot to the ground to maintain balance to protect the affected side from mechanical loading) postoperative rehabilitation protocol after treatment of talar osteochondral lesion (TOL). METHODS: Fourteen patients, who had been treated with arthroscopic debridement and microfracture, were followed prospectively...
March 20, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#16
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28296456/improving-patient-safety-through-the-use-of-nursing-surveillance
#17
Karen K Giuliano
Surveillance and monitoring each represent a distinct process in patient care. Monitoring involves observation, measurement, and recording of physiological parameters, while surveillance is a systematic, goal-directed process based on early detection of signs of change, interpretation of the clinical implications of such changes, and initiation of rapid, appropriate interventions. Through use of an illustrative clinical example based on Early Warning System scoring and rapid response teams, this article seeks to distinguish between nurse monitoring and surveillance to demonstrate the impact of surveillance on improving both care processes and patient care...
February 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28292743/-the-score-matters-wide-variations-in-predictive-performance-of-18-paediatric-track-and-trigger-systems
#18
Susan M Chapman, Jo Wray, Kate Oulton, Christina Pagel, Samiran Ray, Mark J Peters
OBJECTIVE: To compare the predictive performance of 18 paediatric early warning systems (PEWS) in predicting critical deterioration. DESIGN: Retrospective case-controlled study. PEWS values were calculated from existing clinical data, and the area under the receiver operator characteristic curve (AUROC) compared. SETTING: UK tertiary referral children's hospital. PATIENTS: Patients without a 'do not attempt resuscitation' order admitted between 1 January 2011 and 31 December 2012...
March 14, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28277766/impact-of-implementation-of-the-national-early-warning-score-on-patients-and-staff
#19
Scott Farenden, David Gamble, John Welch
The National Early Warning Score (NEWS) has been criticized for increasing workload and decreasing attention to signs of deterioration. This study highlighted the significant mortality of ward patients referred to critical care, and showed that the NEWS identified high-risk patients without increasing workload or worsening outcomes.
March 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28276182/application-of-the-national-early-warning-score-news-as-a-stratification-tool-on-admission-in-an-italian-acute-medical-ward-a-perspective-study
#20
Walter Spagnolli, Marta Rigoni, Emanuele Torri, Susanna Cozzio, Elisa Vettorato, Giandomenico Nollo
AIM: We aimed to assess the performance of the National Early Warning Score (NEWS) as tool for patient risk stratification at admission in an acute Internal Medicine ward and to ensure patient placement in ward areas with the required and most appropriate intensity of care. As secondary objective, we considered NEWS performance in two subgroups of patients: sudden cardiac events (acute coronary syndromes and arrhythmic events), and chronic respiratory insufficiency. METHODS: We conducted a perspective cohort single centre study on 2,677 unselected patients consecutively admitted from July 2013 to March 2015 in the Internal Medicine ward of the hospital of Trento, Italy...
March 2017: International Journal of Clinical Practice
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